Career Development & Geriatric Social Work: Challenges & Opportunities

1. Committee on Leadership in Aging (CLiA) The Hartford Partnership Program for Aging Education (HPPAE) Career Development & Geriatric Social Work: Challenges & Opportunities

2. www.socialworkleadership.org CLiA & Agenda Committee of current student and alumni of the Hartford Partnership Program for Aging Education (HPPAE). Unites aspiring leaders in the field of aging to serve as the internal student leadership committee of HPPAE This webinar will focus on three main areas: • Career paths that are a good fit for social workers specializing in geriatric social work • Exploration of the challenges that a career in geriatric social work presents • Recommendations are offered for supporting geriatricMSW level social workers on their path and encouraging other social workers to focus on this population

3. www.socialworkleadership.org Careers and Career Development in Geriatric Social Work Jenny Cox, LCSW Director, Senior Behavioral Health Center at Sharon Hospital HPPAE Graduate Boston College Graduate School of Social Work

4. www.socialworkleadership.org Entrepreneurial Opportunities for Geriatric Social Workers • Demand for community-based services for the aged is increasing and communities are struggling to meet demand. • Ample opportunities to grow service-related businesses catering to seniors • Medicare advising • Adult day health • Support for aging in place • Aging supports services is a rapidly growing economic sector.

5. www.socialworkleadership.org “Thinking outside the Box” • Limited traditional roles for new MSWs with geriatric concentrations • MSWs with clinical education, a broad understanding of issues confronting an aging population, and human services experience are uniquely positioned to identify service gaps and fill them. • Community funding, grants, and private partnerships for funding.

6. www.socialworkleadership.org Entrepreneurial Opportunities for Geriatric Social Workers • Private Geriatric Care management • Management of private home care agencies • Private practice for psychotherapy focusing on late life mental health issues • Medicare and Medicaid advising, long term care advising • Freestanding adult day health centers and social day programming, senior centers

7. www.socialworkleadership.org Settings well-suited to social workers with aging-specific education • Inpatient geriatric psychiatric units • Outpatient geriatric psychiatric programs (intensive outpatient programs, partial hospitalization programs, traditional outpatient therapy) • Adult day health programs • Inpatient hospitals • Outpatient medical settings: dialysis centers, day surgery settings, primary care settings

8. www.socialworkleadership.org Settings well suited to social workers with aging-specific education • Elder protective service agencies • Aging advocacy and policy nonprofit organizations • Congregate, independent, and assisted living sites, as well as extended care settings    • Managed Medicare and Medicare advantage insurance companies • Community health agencies, Aging Service Access Points, Area Agencies for the Aged, Senior Centers

9. www.socialworkleadership.org Career Options for Non-clinical Geriatric Social Workers • Program development and evaluation • Public Health Research • Utilization management (particularly with regard to Medicare) • Advocacy and Public Policy development • Non-clinical case management (such as in a managed care setting)

10. www.socialworkleadership.org Career Options for Clinical Geriatric Social Workers • Facilitating support groups for both the elderly and the caregivers of the elderly with cognitive impairment • Facilitating disease-specific support groups (persons living with renal failure, diabetes, cancer, etc.) • Psychotherapy with older adults focusing on mental health issues in late life • Clinical case management (in the community for elders with complex medical and mental health needs, or in a long term care setting)

11. www.socialworkleadership.org Opportunities afforded by the ACA • Accountable Care Organizations (ACOs) • Comprehensive Primary Care Initiative • Need for "synthesizing providers" to coordinate care

12. www.socialworkleadership.org Additional certifications and resources • Become certified through the National Association of Professional Geriatric Care Managers: http://www.caremanager.org/ • Become a professional or board- certified case manager: http://ccmcertification.org/

13. www.socialworkleadership.org Erin and Tova Challenges in Geriatric Social Work Tova Messer HPPAE Graduate Rutgers University, School of Social Work Erin Mickelwaite HPPAE Graduate Rutgers University, School of Social Work

14. www.socialworkleadership.org Challenges on the Path • Working with older adults is considered a niche in social work • Many positions working with older adults are considered non-clinical by State licensing boards • Social Work students generally perceive work with the elderly as less desirable (Reed et. al., 2006)

15. www.socialworkleadership.org Challenges on the Path • Geriatric social workers who want to pursue clinical licensure may find this difficult • What can be done to create positions/foster advocacy, etc. for clinically-minded geriatric social workers?

16. www.socialworkleadership.org Challenges on the Path • Some clinical positions, such as hospice social work, may only legally be filled by LCSWs • Organizations that address older adults' mental health needs prefer to hire social workers with LCSWs because it enables them to bill Medicare for mental health services. (See p. 9 of http://www.medicarenhic.com/providers/pubs/Mental %20Health%20Services%20Guide.pdf.) • What is considered clinical in terms of licensure varies greatly by geographic area!

17. www.socialworkleadership.org Challenges on the Path • MSW programs advertise a shortage of geriatric social workers, which encourages and incentivizes students to specialize • Students need assistance to help advocate for, and develop, geriatric social work positions

18. www.socialworkleadership.org Non-Clinical Opportunities in Geriatric Social Work • Examples of important but non-clinical work in geriatric social work includes adult day care; most work in nursing homes, discharge planning; case management; consultation with medical professionals regarding the care and counseling of older adults

19. www.socialworkleadership.org Clinical Opportunities in Geriatric Social Work • Clinical opportunities that do exist include: Caregiver support groups, individual psychotherapy, psychiatric assessment

20. www.socialworkleadership.org Need for Clinical Opportunities in Geriatric Social Work • Older adults diagnosed with caregiver burden, anxiety, depression and complicated bereavement can benefit from psychotherapeutic interventions (Kennedy & Tannebaum, 2000) • For example, Cognitive Behavioral Therapy (CBT)was demonstrated to relieve symptoms of generalized anxiety disorder and reduce or eliminate the need for continued use of psychotherapeutic medications (Wetherell, et. al., 2013) • Expansion of psychotherapeutic interventions in gerontology is warranted given the issue of overmedication of older adults (Huang, A.R. 2012, Drugs and Aging, 29(5))

21. www.socialworkleadership.org Need for Clinical Opportunities in Geriatric Social Work • Historically, cohorts of older adults have been reluctant to seek psychotherapy due to stigma • However, a recent article in the New York Times indicated that this may be changing (Ellin, A. 2013, How Therapy Can Help in the Golden Years, (4/22)) • Research shows effective case management requires the use of clinical understanding and skills. Clinical background for geriatric social workers is greatly warranted (Halipan Soares, H. & Kornfein Rose, M., 1995, Journal of Gerontological Social Work. Vol 22, Issue 3-4, Jan, 43-156)

22. www.socialworkleadership.org CertificationsGeriatric Social Work • NASW-NJ offers a certification in clinical gerontology, the CSW-G, that requires 2 years of post-MSW clinically supervised experience. (http://www.socialworkers.org/credentials/applications/csw- g.pdf) • LCSW- NJ license and 30 hours of clinically- oriented, aging-related CEU’s are required

23. www.socialworkleadership.org Addressing the Issues • How can we create more varied opportunities for geriatric Social Workers?

24. www.socialworkleadership.org Recommendations • School of SW provide an overview for students of opportunities in geriatric social work in local geographic areas • School of SW survey graduates about their experiences seeking employment in clinical and non-clinical geriatric social work • We recommend greater collaboration among professionals in the field of aging to address the shortage of clinical opportunities for recent graduates

25. www.socialworkleadership.org CLIA Recommendations Regarding Career Development Lindsay Prizer, MSW, LCSW Jessica Katz, MSW, LCSW-A HPPAE Graduates University of North Carolina at Chapel Hill, School of Social Work

26. www.socialworkleadership.org Crafting a Resume • Students may not know where to begin • Or if they already have a resume, it should be reviewed and polished • Direct them to career services at their university! • Encourage them to ask for feedback from recently employed social workers

27. www.socialworkleadership.org Interviewing • Preparation is crucial to a successful interview! • Students may not know what supports are available • Direct students to career services: Websites might offer practice interview questions They may offer in-person practice interviews Other resources, like cover letter and resume templates • Offer Information Sessions on job searches and interviewing

28. www.socialworkleadership.org Networking • Tell them to NETWORK NETWORK NETWORK…and did we mention NETWORK? Networking should not first start near or after graduation! • Encourage students to schedule meetings with professors, with internship supervisors, with anyone! • There are networking opportunities EVERYWHERE: Conferences (check out those vendors!) Shadowing other social workers in their area of interest Meet with agencies just to ‘learn what they do’ Talk to guest speakers after class Introduce students to graduates who are now employed • Continually grow the network: tell them to ask the people they shadowed, etc., for their advice on who else they should talk to in their field

29. www.socialworkleadership.org Share Opportunities • Job hunting can be a lonely business • But once employed, graduates should be encouraged to help OTHER students to network • SO gratifying to help others in their search!

30. www.socialworkleadership.org Role of the Faculty • Remember, it is the first-time job-seeking for many • To guide your students: • Help provide introductions and connections • Let students know these options and specific tips (e.g., how to network) • Refer students to others who can help (e.g., career services or former students) • Invite students to ask questions • There are no dumb questions

31. www.socialworkleadership.org Conclusions • Geriatric Social Work is a less established field within the profession and service provision networks are still being built. Therefore, it is an area of social work particularly well suited to entrepreneurially-minded social workers. • There are many different career avenues within geriatric social work for social workers – medical work, psychotherapy, group work, and macro-level work focusing on policy and systems • The population of older adults as a portion of the population is growing, the future of a society where a large proportion of citizens are over age 65 is as yet unclear. Geriatric social workers are well positioned to lead as society changes!

32. www.socialworkleadership.org Conclusions Cont’d • We know there is a growing expansion of the older adult population; what we don’t know is how society is going to adapt to these changes • Non-clinical roles with the older adult populations (hospital discharge planning, case management, care-coordination) are stepping stone jobs that can provide valuable experience • Parlay this expertise into leadership roles within institutions and the community. If opportunities don’t already exist, the field of aging is a great place to create them!